Organization
FLUSHING DENTAL PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MIRA YI (DDS)
(718) 460-9440
Entity
Organization
Contact information
Practice address
3535 149TH ST STE 203, FLUSHING, NY 11354-3785
(718) 460-9440
Mailing address
3535 149TH ST STE 203, FLUSHING, NY 11354-3785
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
051047
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02495687
—
NY
Enumeration date
09/04/2013
Last updated
09/04/2013
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